Magazine article Public Finance

The CCG Challenge

Magazine article Public Finance

The CCG Challenge

Article excerpt

THE GREEK PHILOSOPHER HeraclitUS IS credited with the phrase 'the only constant is change'. At times it seems that nowhere is this more true than in the public sector and, within this, health is high on the list.

We are rapidly heading towards the latest reincarnation of the health commissioning side, with the introduction of Clinical Commissioning Groups. As these new organisations begin to feel their way, the role of their chieffinancial officers will be crucial.

It would be easy to dismiss CCGs as a logical progression from primary care trusts but they are actually quite different They also bring a number of challenges, especially as their introduction is set against the backdrop of wider health reform and cuts in management budgets.

An important feature is the variation in size of the new organisations, from a virtually county- wide CCG to a very small ten-doctor cluster. This highlights for the first time a move towards true localism and away from central control.

In order to better understand the governance and financial management challenges facing these organisations, CrPFA held a workshop last autumn with a small group of new CCG chief financial officers.

The discussion focused largely on three areas: managing the transition, sustainable commissioning and governance. The complexity of the change, with current funding and costs being split among numerous new organisations, provides a real challenge to those involved to ensure that nothing gets lost in transition. The resolution of current issues around baseline allocations will be critical, especially given the constraints on overall resources.

A simplistic view of the new arrangements is that the CCGs will commission services from NHS providers that are truly independent and set up to compete both with each other and with private sector providers.

The reality is much more complicated. The new organisations face a delicate balancing act in the way they commission care - putting the immediate costs ofthat care and the short-term savings required against the need to ensure access to locally based services over the long term. This is particularly the case with acute provision, where a fully developed mixed economy does not yet exist.

Get the balance wrong and the commissioning groups could put the financial sustainability of their local acute trusts at risk. …

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